Kelati A, Gallouj S, Tahiri L, Harmouche T, Mernissi F Z
Department of Dermatology, Faculty of Medicine, Hospital Hassan II, Fez, Morocco.
Department of Anatomopathology, Faculty of Medicine, Hospital Hassan II, Fez, Morocco.
Int J Womens Dermatol. 2017 Jan 30;3(2):100-106. doi: 10.1016/j.ijwd.2016.11.006. eCollection 2017 Jun.
Mycosis fungoides (MF) is a significant diagnostic challenge; it has various differential diagnosis especially at an early stage. Our aim was to describe mimics of MF clinically and histologically, and to define significant diagnostic criteria of the disease.
This was a retro-prospective cohort of 370 patients in whom the diagnosis of MF was suspected clinically.
MF was histologically confirmed in 15.4% of cases and rejected in 84.5%. Other identified histologically diagnosis were eczema, psoriasis; nonspecific dermatitis, lichen, lupus; pseudolymphoma, parapsoriasis and toxidermia. 4 patients with palmoplantar MF were wrongly treated as eczema, and 10 patients with psoriasiform MF were initially treated as psoriasis. We also described the clinical, histological and immunohistochemistry diagnostic criteria for distinguishing MF from benign dermatosis.
Misdiagnosis of MF was a real problem for this study, because it shared common clinical and histological characteristics with other inflammatory diseases like eczema and psoriasis. Therefore, defining significant clinico-histological diagnosis criteria of MF would be of great help and would increase the accuracy of the diagnosis.
蕈样肉芽肿（MF）是一项重大的诊断挑战；它有多种鉴别诊断，尤其是在早期阶段。我们的目的是从临床和组织学方面描述MF的模仿疾病，并确定该疾病的重要诊断标准。
这是一项对370例临床疑似MF患者的回顾性前瞻性队列研究。
15.4%的病例经组织学确诊为MF，84.5%的病例被排除。其他经组织学确诊的疾病有湿疹、银屑病、非特异性皮炎、扁平苔藓、狼疮、假性淋巴瘤、副银屑病和中毒性表皮坏死松解症。4例掌跖部MF患者被误诊为湿疹，10例银屑病样MF患者最初被误诊为银屑病。我们还描述了用于区分MF与良性皮肤病的临床、组织学和免疫组化诊断标准。
在本研究中，MF的误诊是一个实际问题，因为它与湿疹和银屑病等其他炎症性疾病具有共同的临床和组织学特征。因此，确定MF重要的临床组织学诊断标准将有很大帮助，并能提高诊断的准确性。
